A Policy Analysis of HIV Self-Testing Kit Uptake and Accuracy within Tertiary Student Unions in Ibadan, Nigeria

HIV remains a significant public health challenge in Nigeria, with young adults, including tertiary students, being a key demographic. Distributing HIV self-testing (HIVST) kits through student unions is a policy initiative to increase accessibility and reduce stigma. The effectiveness of this model regarding uptake and user-perceived accuracy requires analysis. This policy analysis evaluated the implementation and outcomes of an HIVST kit distribution programme via tertiary student unions in Ibadan, Nigeria. Its objectives were to assess kit uptake among students and to analyse user-reported experiences concerning test accuracy and procedural clarity. The study employed a qualitative policy analysis framework. Data were collected through a review of institutional policy documents and in-depth, semi-structured interviews with key stakeholders, including student union health officers, university health service staff, and student users of the kits. Thematic analysis was used to interpret the interview data. Uptake of kits was moderate, with initial student hesitancy linked to concerns about result reliability and the absence of immediate counselling support. A key finding was the tension between the policy's emphasis on privacy and the reported user need for integrated psychosocial support. Perceived accuracy was high among users who completed the test, but this depended heavily on following clear, illustrated instructions. The student union-based distribution model shows potential for increasing HIV testing access but is challenged by issues of user confidence and support structures. While providing a discreet testing option, the policy did not adequately address the psychosocial dimensions of self-testing. Policy revisions should integrate pre-test information sessions and establish unambiguous post-test referral pathways. Training for student union distributors on basic guidance is essential. Programmes should consider co-locating kit distribution with access to counselling services. HIV self-testing, policy analysis, student unions, Nigeria, uptake, accuracy, tertiary education. This analysis provides evidence for policymakers and university health services on the strengths and limitations of using student unions as distributors of HIV self-testing kits, highlighting critical gaps in support mechanisms that affect programme effectiveness.